Psychiatric hospitalizations among the arab population in israel: A historic cohort study

Background: Ethnic minorities are at higher risk of psychiatric morbidity and disparity in treatment. The Arab minority, including Christians, Muslims and Druze, constitutes 20% of the population in Israel. The aim of this study was to delineate the distinctive patterns and rates of use of inpatient psychiatric services among Israeli minority and majority populations.Methods: A historic cohort study was based on the National Psychiatric Case Register and the Central Bureau of Statistics. All psychiatric hospitalizations between 2000-2013 of Arab population groups (Muslims, n=6,256; Christians, n=864; and Druze, n=849) were analyzed, and compared to those of the Jewish population (n=48,511).Results: Hospitalization rates were lower among the Arab groups, and were lower for women than for men in all groups. Involuntary admissions accounted for 48.8% of all hospitalizations among Muslims. The difference in the risk of re-hospitalization between Muslims and Jews became non-significant after controlling for socio-demographic and clinical variables. There was a trend of decreasing hospitalization rates among all population groups. Conclusion: Despite the trend towards closing the gap, the rate of psychiatric hospitalizations among the Arab minority in Israel is lower than among the Jewish population, specifically regarding women. The variations in utilization of inpatient services and involuntary hospitalization patterns might be explained by stigma, cultural values (reliance on indigenous healers), and problems of accessibility and quality of services.